title: Cost-effectiveness of treatment with etanercept for psoriasis in Sweden.
abstract: OBJECTIVE
  To estimate the cost-effectiveness, from a Swedish societal perspective, of intermittent use of etanercept (Enbrel) with interruptions of use after 24 weeks compared to continuous use of adalimumab (Humira) as well as non-systemic standard of care in patients with moderate to severe psoriasis.
  
  
  METHODS
  A Markov decision-tree model was constructed from clinical trials results. Patients starting etanercept, adalimumab, or non-systemic therapy moved through the model's 10-years horizon. Model input parameters included clinical response rates. Outcome measures included direct and indirect costs and quality-adjusted life-years (QALYs).
  
  
  RESULTS
  The incremental total (direct and indirect) costs per QALY were 1,559,939 kr (<euro>165,354) for adalimumab 40 mg every other week, compared with intermittent once-weekly Enbrel 50 mg, and 93,629 kr (<euro>9,925) for once-weekly intermittent etanercept 50 mg compared with non-systemic standard of care.
  
  
  CONCLUSIONS
  This analysis showed that, with a 470,000 kr (<euro>50,000) per QALY willingness-to-pay threshold, once-weekly etanercept 50 mg, used intermittently, is a cost-effective treatment for moderate to severe psoriasis compared with adalimumab and non-systemic standard of care.
authors.affiliation: RTI Health Solutions, Velocity House Business and Conference Centre, Sheffield, UK. cknight@rti.org
authors.forename: Christopher
authors.initials: C
authors.lastname: Knight
authors.forename: Josephine
authors.initials: J
authors.lastname: Mauskopf
authors.forename: Mats
authors.initials: M
authors.lastname: Ekelund
authors.forename: Amitabh
authors.initials: A
authors.lastname: Singh
authors.forename: Shiyi
authors.initials: S
authors.lastname: Yang
authors.forename: Robert
authors.initials: R
authors.lastname: Boggs
mesh_terms: D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D000068800:Etanercept; D017048:Health Care Costs; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D008390:Markov Chains; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics*; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use; D013548:Sweden; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D000068879:Adalimumab; D000068800:Etanercept